Sharma Sandeep, Banskota Bibek, Yadav Prakash, Rajbhandari Tarun, Bhusal Rajan, Banskota Ashok Kumar
Hospital and Rehabilitation Centre for Disabled Children, Kavre, Banepa, Nepal.
J Pediatr Orthop. 2023 Mar 1;43(3):174-176. doi: 10.1097/BPO.0000000000002338. Epub 2022 Dec 30.
Parents of children with clubfoot are likely to inquire about the need for tenotomy and about any factors that may be predictive. The present study was done to identify factors that may help predict the need for tenotomy in children undergoing Ponseti treatment for idiopathic clubfoot.
A prospective observational study was conducted on patients under 5 years of age with idiopathic clubfoot and no previous treatment history treated at Hospital and Rehabilitation Centre for Disabled Children. The relationship between the Pirani score, Dimeglio score, age, and passive ankle dorsiflexion (DF) and the need for heel cord tenotomy was analyzed using appropriate statistical methods.
Of 83 patients (125 feet) with a mean age of 6 months, 93 feet (74.4%) required a percutaneous tenotomy. The mean initial Pirani and Dimeglio score for 125 club feet was 4.5 (SD=1.68) and 13.5 (SD=6.1), respectively. The mean initial passive ankle DF was -40.4 (SD=22.31). The Dimeglio ( P =0.000), Pirani scores ( P =0 .000), and passive ankle DF ( P =0.000) showed significant association with the need for tenotomy.
This study shows a strong association between initial Pirani and Demiglio scores and initial passive ankle DF as predictive of a heel cord tenotomy. However, age, sex, and laterality were not associated with the need for tenotomy.
患有马蹄内翻足的儿童的家长可能会询问跟腱切断术的必要性以及任何可能具有预测性的因素。本研究旨在确定有助于预测接受潘塞蒂疗法治疗特发性马蹄内翻足的儿童是否需要进行跟腱切断术的因素。
对在残疾儿童医院和康复中心接受治疗的5岁以下、患有特发性马蹄内翻足且无既往治疗史的患者进行了一项前瞻性观察研究。使用适当的统计方法分析了皮拉尼评分、迪梅廖评分、年龄、被动踝关节背屈（DF）与跟腱切断术需求之间的关系。
在83例平均年龄为6个月的患者（125只脚）中，93只脚（74.4%）需要进行经皮跟腱切断术。125只马蹄内翻足的初始皮拉尼评分和迪梅廖评分的平均值分别为4.5（标准差=1.68）和13.5（标准差=6.1）。初始被动踝关节背屈的平均值为-40.4（标准差=22.31）。迪梅廖评分（P =0.000）、皮拉尼评分（P =0.000）和被动踝关节背屈（P =0.000）与跟腱切断术的需求显示出显著相关性。
本研究表明，初始皮拉尼评分和迪梅廖评分以及初始被动踝关节背屈与跟腱切断术需求之间存在很强的相关性，可作为预测指标。然而，年龄、性别和患侧与跟腱切断术的需求无关。
